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Fla. judge in Obama health suit has own med story

Mon Jan 31, 2011 3:05 PM EST
us-news, business, health, us, barack-obama, supreme-court, overhaul, health-overhaul, roger-vinson
Melissa Nelson, Associated Press

President Barack Obama delivers a statement on Egypt in the State Dining Room of the White House, Friday, Jan. 28, 2011, in Washington. (AP Photo/Carolyn Kaster)

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PENSACOLA — The judge who ruled the Obama administration's health care overhaul unconstitutional questioned whether the government was reaching beyond its power by requiring citizens to buy health insurance because everyone needs medical care.

Under that logic, U.S. District Judge Roger Vinson said, the government could force Americans to buy clothes or food. Vinson, who sided with 26 states fighting the much-maligned measure, revealed his own health care story during arguments several weeks ago, an example that helped shed light on his ruling Monday.

When Vinson was a law student and his wife gave birth to their first child, he paid a doctor in cash.

"It amounted to about $100 a pound," the 70-year-old jurist joked in December.

Vinson, an ex-Navy pilot appointed to the federal bench by President Ronald Reagan in 1983, is known for maintaining control of his courtroom while letting everyone have their say. He loves camellia flowers and has handled cases from abortion clinic bombings to veterans rights to racial discrimination.

"I think being a former Navy officer, he is used to being in control of things but not being a tyrant," said attorney Bud Day, a Medal of Honor recipient from the Vietnam War who has tried numerous cases in front of Vinson.

The judge's ruling produced an even split in federal court decisions so far on the health care law, mirroring enduring divisions among the public. Two judges had previously upheld the law, both Democratic appointees. A Republican appointee in Virginia had ruled against it.

The Justice Department quickly announced it would appeal, and administration officials declared that for now the federal government and the states would proceed without interruption to carry out the law. It seemed evident that only the U.S. Supreme Court could deliver a final verdict on Obama's historic expansion of health insurance coverage.

On Capitol Hill, Republican opponents of the law pledged to redouble pressure for a repeal vote in the Democratic-controlled Senate following House action last month. Nearly all of the states that brought suit in Vinson's court have GOP attorneys general or governors.

Vinson ruled against the overhaul on grounds that Congress exceeded its authority by requiring nearly all Americans to carry health insurance, an idea dating back to Republican proposals from the 1990s but is now almost universally rejected by conservatives.

His ruling followed the same general reasoning as one last year from the federal judge in Virginia. But Vinson took it much farther, invalidating provisions that range from Medicare discounts for seniors with high prescription costs to a change that allows adult children up to age 26 to remain on their parents' coverage.

The central issue remains the constitutionality of the law's core requirement that Americans carry health insurance except in cases of financial hardship. Starting in 2014, those who cannot show they are covered by an employer, government program or their own policy will face fines from the IRS.

In one of Vinson's more high-profile trials, he ruled against medical benefits for thousands of military veterans. Day, who has long known the judge, argued the veterans were promised lifetime care by recruiters when they enlisted and that military health benefits shouldn't stop at age 65. The ruling was later overturned by an appeals courts.

Vinson has also served on the Foreign Intelligence Surveillance Act Court, which meets in secret in Washington to approve wiretaps and other surveillance requests in terrorism and other national security investigations. He graduated from the Naval Academy and Vanderbilt University Law School, and was a lawyer in private practice. He became a senior judge handling a reduced caseload in 2005 after he turned 65.

Vinson's first major case was the 1985 trial of two young couples — one married, the other engaged — who were accused of bombing and conspiring to bomb three Pensacola-area abortion clinics. Jurors found the men guilty of bomb making, damaging buildings with bombs and conspiring to make bombs and the women guilty of conspiracy. Vinson allowed the four to remain free on bond for a month before he sentenced the men to 10 years in prison and the women to five years probation.

In another notable decision, Vinson ruled a Florida county's ordinance banning the showing of the film "The Last Temptation of Christ" was unconstitutional. He also approved a 1993 settlement against the Shoney's restaurant chain for $134 million in a racial discrimination lawsuit brought by thousands of black employees.

In the health care lawsuit, Vinson ruled that lawmakers lack the power to penalize citizens for not doing something and compared the provision to requiring people to eat healthful food.

"Congress could require that people buy and consume broccoli at regular intervals," he wrote, "Not only because the required purchases will positively impact interstate commerce, but also because people who eat healthier tend to be healthier and are thus more productive and put less of a strain on the health care system."

Defenders of the law said that analogy was flawed. Insurance can't work if people are allowed to opt out until they need medical attention. Premiums collected from many who are healthy pay the cost of care for those who get sick. Since the uninsured can get treated in the emergency room, deciding not to get coverage has consequences for other people who act prudently do buy coverage.

"The judge's decision contradicts decades of Supreme Court precedent that support the considered judgment of the democratically elected branches of government that the act's individual responsibility provision is necessary to prevent billions of dollars of cost-shifting every year by individuals without insurance who cannot pay for the health care they obtain," White House adviser Stephanie Cutter wrote in an Internet posting.

Outside court, Vinson is known for his love of the flowering camellia tree. He is a longtime member of the Pensacola Camellia Club and is a former president of the American Camellia Society.

"It's become a retirement hobby," Vinson told the Pensacola News Journal in 2009. "You retire and decide it's time to do something with all those camellias growing in your yard. Then you drag your wife into it."

He declined to be interviewed for this story.

___

Alonso-Zaldivar reported from Washington. Associated Press writer Curt Anderson in Miami and AP writers Erica Werner and Pete Yost in Washington contributed to this report.

© 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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  • Public Discussion (30)
lemonray

What a shock...

  • 1 vote
Reply#1 - Mon Jan 31, 2011 3:41 PM EST
RatPoison

to a change that allows adult children up to age 26 to remain on their parents' coverage.

What a shock...

I had a good laugh when I read that oxymoron... so much so that I'm considering adding the phrase to people who can't seem to get their act together and responsibly conduct themselves. Honestly... age 26 and still sucking on mom's breast.

    #1.1 - Tue Feb 1, 2011 1:30 PM EST
    Reply
    amusedrn

    We have to come up with some type of solution to the mess we have created where hospitals MUST treat whomever shows up at their door of the emergency rooms. I am not advocating that we don't treat people because there is a moral and ethical responsibility for all healthcare providers to do so, but the realities are that running a hospital, an emergency room, a lab, etc...cost money. Nothing is for free so we have to figure out a way to fund these services.

    Right now, in many situations, those with insurance are charged a different amount for the same service or care than someone who is self-pay (who may or may not pay the bill no matter what the amount). I can't say that the universal health insurance mandate is the answer, but we have to do something or we will not have the same availability of care if hospitals close.

    Costs are high, but then again, many providers now must practice what is being called "defensive medicine" in response to all of the litigation involved in the medical arena. To the individual who complained about having to get a abd ultrasound due to a marker in a blood screening, if that provider had not ordered that test and somewhere down the line, you ended up with some type of condition or disease state that could have been detected in the early stages by that ultrasound, you would certainly be looking for a way to sue that provider. You would claim that you were harmed because the provider failed to meet the standard of care by failing to do all the necessary tests at the earliest possible moment when there was an indication of a potential problem.

    We want it both ways in this country. We, as a culture, look for redress to wrongs, but we complain when we have to pay for something that we decide at the time, was not required simply because the test was negative.

    Lets face it. There is a problem in this country with allocation of healthcare resources and how to fund them.

    Something has to be done since the system is already strained to the max in so many locations.

    By the way, a good start would be for all of us to try to modify our lifestyles to promote good health (put down the fork, watch your portions, pass up the "all you can eat" places, try exercising more and sitting around less, stop looking for a pill to cure everything when good health habits can make a difference, etc...). The cost of caring for the end result of having such a large number of individuals who qualify as being overweight is staggering now, but it will even greater since the trend has not and is not improving. Look at the top ten conditions/diseases influenced by carrying excess weight and see how much that costs our nation now and imagine how those numbers will increase as a greater proportion of the populace ages (which typically brings with it a weight gain, especially if habits are not changed). Talk about having to pay!

    Really, it might be better to use a tax to cover healthcare so that all can have access earlier and increase the focus on prevention. It is always easier to prevent than to treat.

      Reply#2 - Mon Jan 31, 2011 5:01 PM EST
      BLD

      Amused #2 - What was the most amazing thing about this bill (which I felt was indicative that it's goal was not to fix a problem but to take control) was the issue about the ER. There was not a single thing in the bill that said if you don't take the mandated insurance, you not only pay a penalty but also will not be treated at an ER until you show ability to pay - unless it is clearly a heart attack or you are bleeding to death, etc. If they truly had wanted to fix problems, then they should have included something like that, too.

      As for taxing to make healthcare accessible earlier, it's not going to do any good and I do not want any more of my tax dollars used wastefully. You talk about lifestyle choices and making changes to prevent disease. So what we pay for these people to go to the doctor, who is going to tell them what they have been told for years anyway: lose weight, stop smoking, exercise, change your diet, don't drink so much, ya da ya da. And yet they have not been listening. We have had so much public knowledge about the diseases that smoking causes and about good eating, exercise, et., yet people's habits are getting worse.

      It's been going on for DECADES, yet there is an inverse relationship between worsening habits and the amount of information. I see young kids still smoking and doing drugs, despite the decades of education. They have put nutrition information on food pkgs for decade and no one seems to care. Kids are just getting fatter. You have to realize that no matter what the govt. does or tells you what to do or spends, there can be no change unless and untill the person decides to change, and that is where the problem lies: personal responsibility.

      Too often people now place blame on someone else. They made me buy my kindergarten kid a Big Mac meal. They made me buy a 32 oz soda. They made me smoke. They made me eat a Big Mac and fries and 32 oz soda. It's not MY fault I am overweight by 100 pounds. That is the mindset of people today, and then they sue. Never does a person accept it was their personal choice to smoke or eat what they did or just sit and watch TV. It's much easier to blame someone else for your predicament than to recognize it is your personal responsibility. Until that changes, then people are going to remain in their same state. And the more and more we become a govt. nanny state, the more and more likely there will be no changes.

        #2.1 - Mon Jan 31, 2011 10:22 PM EST
        amusedrn

        First, your point about the ED doesn't make sense in terms of adding a stipulation to the bill about not being treated if you don't have insurance . That is not what is checked first before treatment (try asking the guy with chest pain about his insurance before treating him and you will probably experience a problem somewhere down the road if that is the policy...as in a dead patient on the floor of the waiting room...wait, that already happened in an ED that was understaffed due to lack of funds).

        EDs (they are departments now not rooms) are a part of the larger organization, the hospital, and as such can be an enormous drain of financial resources of a healthcare organization when too many "free flyers" walk through those doors for their healthcare needs. What we need is some way for the EDs to be covered for the costs involved of caring for those without the ability to pay or we will see a reduced level of care in other parts of the hospital (as has happened in many locations) or closures of hospitals that have a disproportionate number of non-paying patients. This has already been happening in areas with a large percentage of uninsured patients so now there is even less availability of healthcare for all residents of that locale.

        As to your point about an inverse relationship between patient education and health outcomes, your data, if you have any other than anecdotal, is flawed. Patient education is effective, particularly within certain populations of patients. Just because you see it, does not mean there has been an increase in drug use, smoking, etc...Historically, some of the disease states we can now treat or modify the course, were just accepted as that was what normally happened as a person aged. Diet, for example, has been found to have a huge impact on cardiovascular health. Take a look at a cookbook from the 1950 or even the 60's and note the high saturated fat, high sodium content of the recipes. People, on the whole, died earlier from disease states where life style modification would have prolonged their life with an increase in the quality of it as well. What we didn't have was an over abundance of low cost, low nutritional quality foods AND the mindset that we are entitled to have as much of whatever we want BECAUSE we want it.

        That is where personal responsibility comes in as well. WE agree on that too. No one forces anyone to buy that Big Mac (or now even purchase the 32 oz full sugar soda with it since you can get other lower calorie beverages or low fat milk) but we all end up paying the price for so many people doing that. Where do you think the funding comes from to care for these people now? The problem is that the load on the system is not decreasing while the funding sources are, even in the private, charity funding hospitals. ( I worked for several and as the economy worsened and people came in with no insurance and sicker than they would have been before being seen, costs soared, staff was cut, patient ratios were raised even in critical care units, and at one point, at least one of those hospitals was at risk for being closed until the board arranged a huge loan on the charity's endowment assests)

        As to obesity, I stated that is a problem that is increasing so we agree on that. But, you are minimizing the type of preventative care that has been proven time and time again by empirical data to correspond to an increase in healthful behaviors. (Preventative medicine is not simply giving someone some information and sending them out the door. THAT seldom works...it is a whole lot more than that.). Preventative care also includes identifying health conditions and disease states at a much earlier stage, giving the patient the treatment and/or life style modification education and support EARLY so that there is a reversal or slowing of the disease process. Do you know how much it costs for one MI hospitalization or a diabetic's amputation hospitalization or how about a pressure ulcer (estimates one of those at a stage IV is a "million dollar wound" in terms of treatment)? Early care equals a reduction in total costs.

        As to personal responsibility, I couldn't agree with you more. That was my point about passing by the all you can eat place or your example of the Big Mac. And, again, you reinforced my point about taxes being wasted already so lets take a look at that first. How many times have we been told there are numerous silly studies out there being funded by the government or crazy prices paid for things the average person can by for next to nothing.

        As to the nanny state argument, that is silly. We already are to some degree. Why do you think Social Security was enacted? Because not enough people were saving for retirement so someone came up with the idea of what was similar to an anuity type program where you paid in and got assured benefits later. Who do you think pays for WIC or the programs for teenage mothers to get an education at a cost supplemented by the government? As with all social groups, we have apparently decided that there is a responsibility of those who can provide to help those who can't.

        Besides, public health affects all of us, whether we have insurance or not. Just think about it the next time you are in line at a grocery store behind someone who is coughing. TB is on the rise and that person just may be in the infectious stage. You wouldn't know, neither would I since it takes testing to identify the causative organism. And don't think stuff like that isn't out there. It is since we have seen these patients come into the hospitals. Were do you think they go when discharged? Back into the communities and who knows if they are taking their meds.

        So yes, we are all in this together whether you like or not.

        • 2 votes
        #2.2 - Tue Feb 1, 2011 10:30 AM EST
        Reply
        blackheywood

        Here comes Universal Health Care. Yeah!!!!

        • 4 votes
        Reply#3 - Mon Jan 31, 2011 5:08 PM EST
        amusedrn

        By the way, that tax money could come from being a bit more prudent with spending (there are certainly many things that have money thrown at them by the government...pet projects, obscure research, grants for really off-the-wall concepts held by some random organization, etc....). Start by doing what the "everyman" has to do when resources are finite and needs shift...change the pattern of allocation. Just think how much money could be diverted to healthcare or health promotion before we even talk about a new tax. Just a thought.

        • 1 vote
        Reply#4 - Mon Jan 31, 2011 5:58 PM EST
        Newbigtech

        It's unconstitutional... Now on to get a real healthcare plan....

        • 6 votes
        Reply#5 - Mon Jan 31, 2011 6:27 PM EST
        ma91744-1401618

        Good, those 26 states can keep there sick. The other 24 states will have health citizens.

        • 1 vote
        Reply#6 - Mon Jan 31, 2011 6:39 PM EST
        Auto 101

        Then you can pay for the 900 lb man's health insurance.

        • 1 vote
        #6.1 - Wed Feb 2, 2011 1:07 PM EST
        ma91744-1401618

        Gladly. Will use the money saved on having less sick people in our state.

          #6.2 - Wed Feb 2, 2011 7:41 PM EST
          Auto 101

          Health care dose not make you healthy much of it is on the choices you make. Some is luck also.

          • 1 vote
          #6.3 - Wed Feb 2, 2011 9:27 PM EST
          Reply
          JW-2561740

          It's George Bush's Fault

          • 2 votes
          Reply#7 - Mon Jan 31, 2011 7:38 PM EST
          Cormeier

          How is being required to have health insurance different from auto or home owners? If that is unconstitutional, so are they. I want nationalised insurance reform in all sectors. At the least public insurance is publicaly accountable insurance.

          • 1 vote
          Reply#8 - Mon Jan 31, 2011 8:35 PM EST
          J Elihu Smails

          You are not required to buy car insurance if you don't drive or own a car. I don't think the government makes you get "bus-rider's" or "car pool insurance". If you own your home free and clear you don't have to have insurance, as it is only required if you have a mortgage in order to cover the lender's principal.

          We are a nation of individual States bound together by a common Constitution. The Constitution was designed to protect individual liberties from the States, provide for a common defense and PROMOTE the general welfare, not mandate it. Our founders didn't want a strong national government.

          Keep your Canadien or English Health Care. We don't want it.

          • 5 votes
          #8.1 - Mon Jan 31, 2011 8:43 PM EST
          BLD

          8.0 - 8.1 already addressed the difference between the health insurance and car and homeowners' insurance. What I want to know is what you mean by "public insurance" is "publicly accountable"?

          • 1 vote
          #8.2 - Mon Jan 31, 2011 10:27 PM EST
          Cormeier

          @BLD

          CEOs are allowed to lie, cheat, scam, and hide, politicians can do so as well, however that would be an abuse of office and grounds for removal. If a corporation gets exposed as liars and cheats, they simply rename the company and hire a new CEO and then act like nothings wrong. But of coarse, since the health care industry is a monopolised one, they don't have to do anything at all, if they want to screw people over then they can and do so with impunity. If a federal bureaucracy ran the system, it would be cheaper, more effective, and accountable to the public its meant to serve. Health care isn't a business, ok it is, but its also a necessity for society, that should make it a publicly provided service under the Constitution.

            #8.3 - Tue Feb 1, 2011 2:10 AM EST
            Jagsjag

            Surely you jest!! You don't have to own or drive a car. No-one forces you to buy a car of any make or model. The homeowner's insurance you refer to is required only if you have a mortgage on you home or condo. If you own it free and clear, no insurance is required since the only loser will be you should a fire or natural disaster strike. Homeowner's insurance protects the lender should their collateral become impaired and the owner be unable to repair the damage.

            • 1 vote
            #8.4 - Tue Feb 1, 2011 11:21 AM EST
            Cormeier

            If you don't live in New York or L.A. you do have to drive a car, there is no public transportation in most places. Are people just supposed to walk 20 miles to work everyday? And most people have to have a mortgage to buy a home, very few have enough money not to. Nobody forces you to, but you do have to by necessity. On that line of thinking you don't "have" to own any insurance at all, but you probably should.

              #8.5 - Tue Feb 1, 2011 6:18 PM EST
              Auto 101

              Health care isn't a business, ok it is, but its also a necessity for society, that should make it a publicly provided service under the Constitution.

              NO you are wrong for years most people only had catastrophic insurance.

              you do have to drive a car, there is no public transportation in most places. Are people just supposed to walk 20 miles to work everyday?

              Have you ever heard of car pooling? they are still not forced to buy a car.

              And most people have to have a mortgage to buy a home, very few have enough money not to.

              So are you saying people should be forced to buy a home? that will make jobs and increase house prices. how about every one is now required to buy a phone? or get a collage degree?

                #8.6 - Wed Feb 2, 2011 1:21 PM EST
                BLD

                8.3 - You said: If a federal bureaucracy ran the system, it would be cheaper, more effective, and accountable to the public its meant to serve.

                May I ask your age, because this statement reeks of naivite and not much experience in life. NO federal bureaucracy runs a system more effectively or cheaper. Look at the USPO. They are so in the red, and the only way they are afloat is because of being underwritten with YOUR tax dollars. If UPS or Fedex were the USPO, they would have been out of business a long time ago. And, in case you didn't know, the head of the USPO got a BIG bonus in the past couple of years, despite the fact they constantly are operating in the red. If that were a corporation, you would be screaming bloody murder.

                Look at education, too. Govt. funding = inefficiencies and meddling which in turn equals poor education for our kids. Our education system is so concerned with political correctness, unions, and trying to throw money at the problem, they can't see that maybe the system isn't working. Maybe we need to go back to basics and teaching our kids instead of trying to throw money to fix the problem.

                • 1 vote
                #8.7 - Tue Feb 15, 2011 7:09 PM EST
                Reply
                J Elihu Smails

                Maybe we will get a real debate on health-care now, not like the sham perpetrated on us simple folks last year. The left's dream of the "public option" and Universal HC will now disintegrate into a center-right deal. Elections sometimes have positive consequences.

                • 5 votes
                Reply#9 - Mon Jan 31, 2011 8:37 PM EST
                yeagerdog

                The Supreme Court has already ruled that illegal aliens can have free medical care (medicaid), free food (food stamps), free money(welfare), as well as subsidized housing and free education for their illegal children. What I don't understand is, why an american citizen can't have any of these freebes without so many of you out there all up in arms about it. Health care should be a priority for this country, but that is clearly not the case.

                • 1 vote
                Reply#10 - Mon Jan 31, 2011 9:12 PM EST
                DS12

                Lets ask Scalia...wait the Tea Party already had him over to "talk" at one of their recent functions.

                • 1 vote
                #10.1 - Mon Jan 31, 2011 10:18 PM EST
                Reply
                ScienceGuy-356641

                Judge Vinson to Family Research Council:

                "Tell me what to say, and I'll say it. Tell me what to write, and I'll write it. Tell me what to think, and I'll think it."

                • 1 vote
                Reply#11 - Mon Jan 31, 2011 9:55 PM EST
                crispy2000

                Nancy Pelosi to Vladimir Illyich Lenin:

                "Tell me what to say, and I'll say it. Tell me what to write, and I'll write it. Tell me what to think, and I'll think it."

                There.  Fixed it for you.

                • 3 votes
                #11.1 - Tue Feb 1, 2011 9:36 AM EST
                Reply
                BLD

                All I can say is YEA, YEA, YEA. I wish I could have seen the Anointed One, Nancy P. and Harry R. have hissy fits when they heard. I bet he jutted out his jaw in front of the mirror and asked how dare the Judge tell him he was wrong. I bet he had to have a Stuart Smally moment to re-affirm how wonderful he is (in his own mind). Ha! I can't wait until the Supreme Court tells him he is wrong.

                • 3 votes
                Reply#12 - Mon Jan 31, 2011 10:25 PM EST
                Jagsjag

                I certainly believe that this health-care law is unconstitutional and is promoted by those who think that health-care should be provided as a "right" and paid for by someone else. I'm sure that all of the drug dealers, robbers who hold-up liquor stores & 7-11's, and general thugs who we see every morning on the TV news being hauled away to have their bullet wounds fixed at taxpayers expense will be the first to sign-up for their insurance. "Rights" come from God, the exercise of which infringes on the "rights" of no-one else but health-care comes from the men and women who have made the sacrifices necessary to obtain the skills required to provide this care. They deserve to be compensated by those who receive those services at market rates & not by the government or insurance companies or taxpayers. Man-up and build your health-care insurance premiums into your budget (you know, ahead of the cable guy and your i-pod) and make insurance available across state lines and the free market will lower your costs far more than any gov't. program.

                • 1 vote
                Reply#13 - Tue Feb 1, 2011 8:05 AM EST
                amusedrn

                Thank you for mentioning the men and women who have made the sacrifices in order to have the skills and knowledge to be effective healthcare providers. I have had several careers, am on my 5th degree (changed completely so I started all over, from the beginning for the healtcare ones), working on a second masters to become a practitioner, and honestly, no matter what else I have studied, there was never more to learn and master, particularly in such a short space of time, to such a level of proficiency (or you will be sued in practice...you still might anyway) compared to what is required as basic knowledge for the healthcare field. Funny thing is, my daughter, who is doing her bachelor's for pre-med said she can't even watch a show where actors are portraying physicians since "those people have no clue as to how much work it is just to get to be able to apply to medical school!" She is right, most people have no clue as to what it takes to become a physician, physician assistant, nurse practitioner, a nurse, pharmacist, etc... Most of the time, the person spends YEARS in school, YEARS paying back the loans it took to get the education so those who talk about the whole big salary thing are ridiculous. Society needs healthcare workers and not a large number of individuals have the ability to make it to that endpoint so you are right. The marketplace should be what dictates compensation.

                Love your point about budgeting and priorities.

                • 2 votes
                #13.1 - Tue Feb 1, 2011 10:55 AM EST
                Reply
                amusedrn

                I should have said at least decade in higher ed (4 yr. degree plus med school plus residency, then potentially more for certain areas) and decades paying back the loans. Years was not explicit enough to show just how long these people work to master the skills and acquire the knowledge base to go out and take care of others. Wow...what a deal we are getting in some of them now!

                • 1 vote
                Reply#14 - Tue Feb 1, 2011 6:14 PM EST
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